# Diagnostic Challenges in Acute Infantile Epididymitis: A Case Report

## TL;DR

This case report highlights the diagnostic difficulties of acute epididymitis in infants and the importance of using clinical evaluation and tests to avoid unnecessary surgery.

## Contribution

The paper presents two infant cases of acute epididymitis and emphasizes the diagnostic approach to differentiate it from surgical emergencies.

## Key findings

- Acute epididymitis in infants can mimic conditions like hernia and testicular torsion, requiring careful evaluation.
- Scrotal ultrasound and urinalysis are effective in diagnosing epididymitis and avoiding unnecessary surgery.
- Surgical exploration may still be necessary in some cases to confirm the diagnosis.

## Abstract

Acute epididymitis is a rare yet significant cause of acute scrotum in infants, which presents diagnostic challenges owing to its similarity to other conditions requiring emergency surgery, such as strangulated inguinal hernia and testicular torsion. This report describes two cases of acute epididymitis in infants, emphasizing the importance of differential diagnosis in the emergency department. In case 1, a six-month-old male infant with swelling and erythema extending from the right groin to the scrotum was initially suspected of having a strangulated inguinal hernia. However, scrotal ultrasonography and urinalysis confirmed an acute epididymitis, and the patient responded well to antibiotics. In case 2, a three-month-old male infant with scrotal erythema and swelling required surgical exploration to rule out testicular torsion and was ultimately diagnosed with acute epididymitis. The patient was cured with antibiotics without relapsing. This report underscores the role of clinical evaluation, scrotal ultrasound, and laboratory tests such as urinalysis and serum C-reactive protein levels in diagnosing epididymitis and differentiating it from other acute scrotal conditions. However, surgical exploration is a useful diagnostic tool for acute infantile epididymitis. Early and accurate diagnosis of acute epididymitis using these examinations is crucial for preventing long-term complications.